Provider Demographics
NPI:1003864638
Name:SWIRSKY, STEPHEN M (DO)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:M
Last Name:SWIRSKY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6853 SW 18TH ST STE M111
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33433-7056
Mailing Address - Country:US
Mailing Address - Phone:561-617-7996
Mailing Address - Fax:561-228-0318
Practice Address - Street 1:6853 SW 18TH ST STE M111
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33433-7056
Practice Address - Country:US
Practice Address - Phone:561-617-7996
Practice Address - Fax:561-228-0318
Is Sole Proprietor?:No
Enumeration Date:2006-05-05
Last Update Date:2023-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS8222207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL260076500Medicaid
FLK6961Medicare PIN
FLE4559YMedicare UPIN